Potential effects of TSH suppression for thyroid cancer

[Nanaedake]

Something to discuss if treated for thyroid cancer is the degree of supression.

healio.com/endocrinology/th...

[Clutter]

Nanaedake,

I've been having this argument with my endo for over 2 years. She wants TSH less suppressed but I've declined further dose increases and have said I'll take my chances with osteoporosis and atrial fibrillation.

[Nanaedake in reply to Clutter]

Apparently eating 5 prunes a day keeps osteoporosis at bay - something to do with boron. As for AF, if doctors tested FT3 then we would have a better idea of where we stood to make sensible decisions.

[Clutter in reply to Nanaedake]

Nanaedake,

My FT3 is tested. I make sure it is within range. I have osteopenia and am hoping it won't get worse now that I supplement vitD.

[Nanaedake in reply to Clutter]

How did you discover you had osteopenia?

[Clutter in reply to Nanaedake]

Nanaedake,

Dexa Scan endo ordered 3 years ago after I told him that contrary to his assumption that vitD was fine when he refused to test it, GP tested and I was severely vitD deficient.

[Nanaedake in reply to Clutter]

I hope the vitamin D prevents it getting worse. I had a Dexa scan but no results yet. 2 fractures. Vitamin D good after 2 years supplementing so I'll wait and see.

[Clutter in reply to Nanaedake]

Nanaedake,

VitD has been good since then so I'm hoping osteopenia is better, or at least not worse. I'm supposed to be having a repeat Dexa scan but appt hasn't come through. I need to chase it up before my annual endo consult in the spring.

[blondpalomino in reply to Nanaedake]

I also have osteopenia,my endo ordered a scan as my TSH is supressed.It's probably not necessarily to do with this as my Mum and sister both have osteoporosis but they don't have thyroid problems, so in my case it's genetic which my doctor agreed.

[Inaquandary in reply to Clutter]

Clutter - my onco wants my TSH suppressed, I am on 150/175mcg alternate days. Now on beta blockers. She talked about this dose being kept up for 9 months??! Feel awful on it. Have I got an argument? TT for papillary cancer and lymph node removal 7 weeks ago, RAI. 7th DEC.

[Nanaedake in reply to Inaquandary]

Inaquandary not sure if you've discovered yet that if you want to be sure Clutter or someone specific sees your post you can tag a person. Use the @symbol then type their name and a selection list pops up below the area you are typing. You can then select that person to tag and notify them.

[Clutter in reply to Inaquandary]

Lindsaydawson603,

I had suppressed TSH but still had FT3 below range. Thyroidless don't always do well on Levothyroxine only. If you post TSH, FT4 and FT3 results and ranges I can advise. Include any ferritin, vitD, B12 and folate results too.

Best to write your own post so Nanaedake doesn't get a flurry of notifications.

[Inaquandary in reply to Clutter]

Ok will do. Test results tomorrow. Thank Nana and C 😀

[Inaquandary]

This is me. What does it mean?

[Margo]

I am with you Inaquandary , could somebody please explain what it means?

[SilverAvocado in reply to Margo]

Inaquandary I'll try to summarise what I got out of it. Basically thyroid cancer patients, 18 years later, have a higher risk of some cardiovascular issues. I don't have the paper open, but this includes atrial fibrillation, arrhythmia, and admission to hospital generally.

But the risk of death from a cardiac event is considerably lower. If I'm interpreting the figures right, the greater risk tends to be about 10-18%, but the risk of death is more then 20% less.

They then separate out the group that have a very suppressed TSH and add some additional tests. It didn't make much of an impression on me, but what did impress on me is that the thyroid cancer group as a whole didn't have such a low TSH. So this isn't a comment about having the kind of very low TSHs we tend to have on this forum. It seems like the added risks come from a TSH that's only a little below reference range. And it may be things like RAI and the shock of surgery (or shock of having cancer in the body), or something unknown about not having a thyroid, that gives these increases and not the higher dose of thyroid hormone.

But because there is greater risk for some things, but a much lower risk of dying from a cardiac event, it seems like a suppressed TSH is like a lot of other things, it ups your risk for one thing, but is protective for other things.

Although the bad news would be that this is some evidence atrial fibrillation can be caused by a higher dose of thyroid replacement, which is what doctors are always claiming. But the authors don't particularly claim its the case, and the water is muddied quite a bit by all the confounding factors cancer patients face. And the comparison group is the whole population, not other thyroid patients with lower doses of replacement. I think you'd expect cancer patients to be a bit worse off than the whole population, which will include some sick people, but also many people that are fit as a flea.

[Hidden]

Very interesting the follow up being 18 years. I do know since having my thyroid removed two years ago and having it suppressed my heart rate has increased from 68 to 85.My blood pressure has remained the same 120/80 The increase in heart rate being partly due to the wrong medication and not being able to get fit through exercise i.e. being fatigued all the time. Now that I am back with the correct medication I hope to decrease my heart rate and am walking and doing qigong everyday.

[Margo]

Thank you SilverAvocado